AB1580 ULTRASOUND FINDINGS IN PATIENTS WITH GOUT IN A POPULATION OF THE DOMINICAN REPUBLIC
Authors: D. Garcia, R. A. Alvarez Santana, L. Perez Rodriguez, T. Polanco Mora, L. Concepción Sanchez, I. Mercedes, I. Paulino, E. Rodriguez Bautista, T. Valdez, A. Feriz, R. Muñoz Louis
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Hyperuricemia is an increase in the serum concentration of monosodium urate (MSU). Gout is secondary to the inflammatory response elicited by the deposition of UMS in the tissues. It is the most frequent inflammatory arthropathy in the general population. [1] Its prevalence has been estimated at 2-3% of the adult population. [2] The ultrasound findings observed are considered within the ACR/EULAR 2015 criteria, which derive from the presence of UMS deposits in the subcutaneous tissue and in intra- and periarticular areas (cartilage, tendons, ligaments, and bursae. [3]. There are 2 specific findings of MSU deposits: 1) enhanced echogenicity of the chondrosynovial margin (double contour sign), presence of hyperechogenic aggregates, which, in turn, can have 3 forms of presentation: hyperechogenic dots (&lt;1 mm) within a joint effusion, (cotton-wool areas) (&lt;1 cm) homogeneous without posterior acoustic shadow and larger tophi with calcifications and posterior acoustic shadow [4]. <h3>Objectives</h3> To identify the ultrasound findings in patients with gouty arthritis in a population of the Dominican Republic. <h3>Methods</h3> Descriptive, prospective observational study. From the cohort of patients from the Rheumatology service of the Hospital Docente Padre Billini, patients from the outpatient clinic were evaluated from June to December 2022. Inclusion criteria: &gt; 18 years, diagnosis of gouty arthritis according to ACR\EULAR 2015 criteria, presence of at least 1 attack of gouty arthritis, performance of joint ultrasound Exclusion criteria: Osteosynthesis material in areas evaluated by ultrasound and/or infiltration, traumas of less than 3 months in the evaluated joints. Elbows, wrists, 2nd metacarpophalangeal MCP, knees, and 1st metatarsophalangeal MTF were evaluated by ultrasound, recognizing positive findings of double contour sign, hyperechogenic aggregates, erosions, synovitis, and irregularities according to OMERACT definitions. Made with the Siemmens Acuson X 150 ultrasound machine, with a 13 mHz transducer. Descriptive statistics were performed with SPSS 25 V2. <h3>Results</h3> 52 met inclusion criteria. 100% male, mean age 59±16.1 years, mean disease duration 8.6 years, mean serum uric acid 9.5 mg/dL. BMI: overweight 32.7% (17), grade I obesity 21.2% (11), grade II obesity 40.4% (21). Diabetes mellitus 55.8% (29). Arterial hypertension 57.7% (30). Dyslipidemia 80.2% (42). Colchicine 61.5% (32), Allopurinol 48.1% (25). Febuxostat 48.1% (25), NSAIDs 48.1% (25), Prednisone 46.2% (24), Benzbromarone 3.8% (2) Ultrasound findings 55.7% (29): Elbows: irregularities 37.9% (11), Tophi 37.9% (11), erosions 20.7% (6), Carpals: Erosions 10.3% (3), aggregates 10.3% (3), power Doppler 2.69% (2), irregularities 31% (2), Knees: erosions 27.6% (8), irregularities 27.6 % (8), double contour 20.6% (6) power doppler 10.3% (3), tibiotalar: irregularities 27.6% (8), erosions 17.2% (5); 1st MTFs: erosions 48.2% (14), irregularities 27.6% (8), aggregates 3.4% (1). <h3>Conclusion</h3> The study demonstrated that more than half of patients with gout present structural lesions by ultrasound according to OMERACT. The elbows are the most affected joints with the presence of tophi, followed by the first metatarsophalangeal joint with the presence of erosions. <h3>References</h3> [1]García Puig J, et al. La ecografía en el diagnóstico de la hiperuricemia asintomática y la gota. Rev Clin Esp. 2016. [2]Dehlin M, Jacobsson L and Roddy E. Global epidemiology of gout: prevalence, incidence, treatment patterns and risk factors. Nat Rev Rheumatol 2020; 16: 380–390 [3]Scirocco C, Rutigliano IM, Finucci A, Iagnocco A. Musculoskeletal ultrasonography in gout. Med Ultrason. 2015; 17:535-0. [4]Naredo E, Uson J, Jiménez-Palop M, Martínez A, Vicente E, Brito E, et al. Ultrasound-detected musculoskeletal urate crystal deposition: ¿Which joints and what findings should be assessed for diagnosing gout? Ann Rheum Dis. 2014; 73:1522---8 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.